Appalling child neglect in Christchurch caused the worst case of head lice a doctor has seen in a decade. How can children become the victims of extreme neglect when there are agencies to look after them?

Who is looking after the children?

In many cases where the answer is "not their parents", safe and sensible alternatives will have been put in place by Child Youth and Family (CYF). But given news of the awful neglect of two young children in Christchurch, it would appear CYF intervention may not always be for the better.

The case exposed this week makes for shocking reading. An 8-year-old girl and her 7-year-old brother are the victims of serious neglect, suffering from appalling health issues which are entirely preventable and treatable. They have been cared for by a grandparent since they were babies.

How can we eliminate poverty?

Share your stories, photos and videos.

This in a relatively affluent city in New Zealand.

Last month, the children's carer rang the home of a family friend to ask if she could pick them up from school. The friend was subsequently horrified to discover how their health had suffered since the last time she cared for them, about a year earlier.

The girl had psoriasis, a boil caused by malnutrition and the worst case of head lice their doctor said she had seen in a decade. The boy was seriously underweight at just 18kg and had impetigo on his chest, which had been covered over with two dressings. Both were sick when they were fed by the friend.

After taking the children to CYF the following day, she kept them at her two-bedroom flat for another night before visiting the doctor and returning them to their mother, because she feared she would be reported for "kidnapping them" if they stayed with her. The children have since gone back to their carer's home.

Christchurch City Missioner Michael Gorman and Family First NZ national director Bob McCoskrie have reacted strongly, and appropriately. McCoskrie says intervention for the children's sake is clearly necessary and that earthquake issues cannot be used as an excuse. Gorman says he believes this has to be at the "extreme" end of the neglect scale.

The level of neglect in this case is extremely disturbing. What seems particularly startling is how those who have had close contact with the children during the past year have either failed to notice their deteriorating health, or have noticed but done nothing about it. Or, perhaps they have tried to do something about it but the system has blocked or rebuffed their efforts.

It is difficult to know the real story. It would be easy to think surely the children's teachers noticed? Or classmates or their parents? However, without seeing specific signs of neglect, other than head lice, it is difficult to act on assumptions.

It would also be good to know how regularly CYF checked on the children over the past year. CYF was clearly OK about them going back to their carer's home despite the concerns raised by the family friend.

CYF has not yet commented on this case. While privacy concerns are understandable, children are the concern not only of the family they live with but their wider community. This community has raised concerns about the care of these children and deserves to know something is being done to improve it.